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Related Party Transactions - Fees Incurred and Income Received (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Related Party Transaction [Line Items]        
Net total $ 10,979 $ 34,382 $ 37,858 $ 66,141
AHMC        
Related Party Transaction [Line Items]        
AHMC – Risk pool and Capitation 11,215 35,771 39,165 69,169
HSMSO        
Related Party Transaction [Line Items]        
Management fees, net (160) (1,311) (1,075) (2,786)
Aurion        
Related Party Transaction [Line Items]        
Management fees, net $ (76) $ (78) $ (232) $ (242)